Premature Ejaculation and its treatment

PME Overview

Early / Rapid (Premature) Ejaculation is not a disease The most common sexual dysfunction in men is Premature Ejaculation (PE). In fact it is more common than common cold and will not go away by itself, unless diagnosed and treated.
Premature Ejaculation happens before penetration or after penetration before partner achieves satisfaction. Men with PE have short ejaculation times from penetration to ejaculation, inability to delay ejaculation and negative personal consequences from PE.

Adequate ejaculatory control refers to a reasonable degree of voluntary control, which allows a man to continue to continue sexual performance, until he chooses to “let go” and ejaculate. Most guys are able to prolong their sexual act, on the basis of partners need for 3 to 7 minutes.

Premature ejaculators are unable to achieve this level of voluntary control and they have no choice and they ejaculate rapidly and involuntarily as soon as they reach a high state of arousal, whether they want it or not. Many men with early ejaculation attribute it to guilt about masturbation, lack sexual confidence and they tend to be anxious about their ability to perform. Each time their negative experience convinces them that they are “losers” and this increases their performance anxiety. During anxiety there is a release of adrenalin and nor adrenalin which are our body’s emergency hormones which reach penile circulation in less than a second and instantly constricts the blood vessels reversing the erectile process and they naturally lose the erection also, which can be devastating.

Lifelong PE is characterized by 'ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration leading to frustration of the partner.



In our society, men often measure their self worth by the hardness of their erection and by their “staying power”. Men who have poor control, especially if they are unsure of themselves in other ways, may end up with a general sense of inadequacy and failure, and may develop additional sexual difficulties. Early ejaculation is not good for romantic relationships, not because women reject them on account of the PE, but because they develop self-destructive patterns of sexual avoidance and lead a bitter and frustrated life. Many women who complain bitterly about their husband’s PE are really less upset about their PE, but are more concerned by the partner’s insensitivity to their feelings. Naturally, such deep unhappiness on the part of the partner creates pressures, which only worsen the couple’s problems, and in fact they avoid having sexual activity.

The only way to diagnose is when the individual feels or the partner complains about it.

Treatment

Preventive Exercise

By modifying the stimulation in masturbatory exercises (Stop-start technique), Yoga (Vajroli & Ashwini Mudra), Unani approach (interrupting the flow of urine) a man with premature ejaculation can learn to slow his response or in severe cases surgical cutting of the nerve.

Reducing sensation

Wear a condom: sounds too simple to be true, but it works for a lot of men.

Use an analgesic cream or spray: There are two classes of these products. The first is the traditional "numbing" creams and sprays that have been on the market for some time. The upside is that you'll feel less sensation, which will delay ejaculation. The downside is your partner may suffer a loss of sensation as well and of course less sensation is not very appealing to men and women.

There is a new class of topical medications that absorb into the skin to deliver a mild anesthetic to the sensory nerves below the stratum corneum (top layer of skin) of the penis. This allows men to have ejaculatory control but with less loss of sexual sensation, and reduces the transference to their partners.

Apply strategic pressure:

Youcan delay an oncoming ejaculation by applying pressure to one of two spots.

Perineum pressure: Pressing on the perineum by yourself or your partner, a spot midway between your scrotum and your anus, will help to stop ejaculation because this spot reaches through to the prostate gland. It is the prostate that contracts and expands during orgasm and then expels the ejaculation fluid.

Testes tug: When a man nears orgasm his scrotum raises up closer to his body. You can delay ejaculation by gently pulling your testes down and away from your body.

Reduce anxiety:

For many men anxiety and pressure to perform is a major contributor to premature ejaculation. Relax and remember that your partner probably cares about more than the timing of your orgasms, and that premature ejaculation doesn't mean you can't still be good in bed

Medications

Selective serotonin reuptake inhibitor (SSRI), group of drugs delay ejaculation.

In very severe cases, rarely surgical option is considered, to denerve the penis of its sensations.

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